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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa

David’s Guide to Getting Our A1C Under 6.0

June 17th, 2009 · 57 Comments

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The A1C test is our best scorecard to show how well we are controlling our diabetes. It measures how much glucose has been sticking to our red blood cells for the previous two or three months. Since our bodies replace each red blood cell with a new one every four months, this test tells us the average of how high our glucose levels have been during the life of the cells.

The experts recommend that we should get our A1C level tested at least twice a year. People who take insulin need to get it about four times a year.

If the test shows that our blood glucose level is high, it means that we have a greater risk of having diabetes problems. Think of the A1C as an early warning system for the insidious complications that we can get down the road when we don’t control our condition.

But what do we mean by a “high” A1C level? Here the experts disagree.

The American Diabetes Association says that we need to keep our A1C results below 7.0 percent. The American Association of Clinical Endocrinologists sets the target at 6.5 percent. The International Diabetes Federation, or IDF, also recommends that most people with diabetes keep their levels below 6.5 percent.

The more our A1C level is higher than normal, the greater the likelihood that we will suffer from one or more of the complications of diabetes. And here too the experts disagree with how they define “normal.”

People who don’t have diabetes have A1C levels below 6.0 percent. That’s the gist of what I wrote here recently in “The Normal A1C Level.” The IDF agrees. But more aggressive endocrinologists say that a truly normal A1C ranges from 4.2 percent to 4.6 percent. That’s what Dr. Richard K. Bernstein wrote in Dr. Bernstein’s Diabetes Solution.

No matter what our level is, we can be sure that lower is better. Unless we drive it so low with diabetes drugs that we run risks of hypos or heart problems. Concerns with these risks are the main reasons why our diabetes organizations set a goal that is higher than a normal level — even though they know from clinical trials, like the UKPDS and the DCCT, that with higher levels we will probably suffer from the serious complications that result from high levels.

Then the question becomes what is our best strategy to bring our A1C level down to normal. Not surprisingly, the experts disagree here too.

The key has to be the level of carbohydrates in our diet. After all, like Dr. Bernstein says, diabetes is a disturbance of carbohydrate metabolism where our blood glucose rises above normal.

But for years the ADA has told us that “The recommended dietary allowance for digestible carbohydrate is 130 grams per day.” On the other hand, Dr. Bernstein’s diet allows no more than a grand total of 42 grams carbohydrate each day. While his books don’t say, he has told me directly that he’s talking total carbs, not digestible carbs.

I know from my personal experience that Dr. Bernstein’s restrictions on carbohydrate do indeed bring our A1C levels down to normal. My most recent test was 4.8 percent — without drugs.

Even before 2007, when I began following a very low-carb diet, for about two years after 2005 one diabetes drug helped me reduce my A1C from 6.8 percent. I know that Byetta works to help us achieve diabetes control, especially when we eat fewer carbs, as I began to do then.

The further benefit of both a very low-carb diet and Byetta is that they will help us control our weight far better than anything else. Since more than 85 percent of all of us who have diabetes are overweight or obese, according to a survey by the U.S. Centers for Disease Control and Prevention, I have to conclude that controlling our weight is a key step in controlling our diabetes.

With diet and weight loss alone we may be able to get our A1C level down to 6.0 or better. But we can sure make it easier on ourselves if we ramp up our metabolism. Physical exercise reduces our blood glucose by improving our glucose metabolism, according to recent studies. That’s the best reason for us to get at least the recommended minimum of 150 minutes of moderate-intensity exercise each week.

The other leg of diabetes control has always been to take one of the 10 classes of diabetes drugs we can use. Until we bring our A1C level down to normal, taking one of these medications is essential. I know that taking a couple brands of sulfonylureas and then metformin helped me before I was able achieve my greatest benefit from Byetta.

We tend to forget the importance of reducing the stress in our lives through readily available tools like relaxation and meditation. Likewise, we are just beginning to realize the huge role that reducing inflammation can play in getting control of our diabetes.

Even the amount of sleep that we get can help us control our weight, which probably will help us control our blood glucose level. A new study less than a week ago shows that identical twins who slept between 7 and 8.9 hour each night weigh less than those who regularly sleep either less or more.

These tools are the keys to getting our A1C levels down to normal so we can control our diabetes, instead of letting it control us. All of them are important. But nothing works better than a very low-carb diet.

This article is based on an earlier version of my article published by HealthCentral.


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57 responses so far ↓

  • 1 Carol // Jul 29, 2009 at 9:26 pm

    I have always had a normal glucose level. This year it was 113 which my doc said was high. They did an A1C which came back at 6.3 which they said was high. I am wondering if eating a lot of chocolate during the previous 4 months would give an abnormal test result. I have never been diagnosed as diabetic and don’t have any symptoms. I am just barely 62 and no more overweight now than I was the last 30 years of my life. Just wondering whether a chocolate binge affected the test result. Any thoughts?

  • 2 David Mendosa // Jul 30, 2009 at 7:35 am

    Dear Carol,

    You are right on the borderline of having diabetes, and your weight doesn’t necessarily cause it.

    As to chocolate, not likely. In the first place, chocolate per se has little effect on blood glucose. The sugar in most chocolate does, but only to much extent among people who have diabetes.

    You have been warned by your doctor that you are on the road to full-fledged diabetes. Please take the necessary steps now to avoid it. Those steps are most importantly to get a lot of exercise and control your weight by eating right, i.e. by avoiding a lot of carbohydrates, particularly the sugars and starches like wheat flour (and anything made from it like bread), potatoes, rice, and corn.

    Best regards,


  • 3 Carol // Jul 30, 2009 at 3:10 pm

    So, then, how quickly can a 6.3 A1C turn into a 6.5? or higher. HELP! How much time do I have? And, I also sent an email reply. Did you get it? I’m trying to maintain decorum here. LOL

  • 4 David Mendosa // Jul 30, 2009 at 6:21 pm

    Dear Carol,

    The difference from an A1C of 6.3 and one of 6.5 is not statistically significant. If I didn’t answer your email, I didn’t get it!


  • 5 Donna Oman // Jul 31, 2009 at 1:31 pm

    hi dave– i just saw a picture of you at your new weight! I knew you lost weight, but the picture is
    inspiring!! Great work!

    I have a question regarding how you are maintaining your weight. I’m BMI 22, A1C 5.9, and eat low-carb, use metformin, ALA, and vinegar. Problem is that while statistically my weight is fine (all advisors say why bother to lose weight), I’m left with handfuls of fat rolls around the waist!, which I suspect contribute to why I can’t seem to get my A1C down further.

    I’ve tried lots and lots of exercise–run, bike, hike, swim, triathlons–but I’m really tired of so much exercise which isn’t giving me the results I want–and, the more I exercise, the more I need to eat (even tho it’s lo carb)!

    Specifically my question is 1)are you following Dr. B’s diet exactly–ie, do you strictly! monitor carbs to the 30 that he recommends, 2)are you reducing your calorie intake or your fat intake as well? (contrary to G. Taubes, etc.)

    thanks for any recommendations you can give me.

    Donna Oman

  • 6 David Mendosa // Jul 31, 2009 at 5:27 pm

    Dear Donna,

    It’s not easy to for me to keep my weight off! I weigh myself every day when I’m home, and when my weight creeps up more than a pound or two, I immediately cut back on how much I eat. While I don’t count carbs or calories, I pretty know the contents of foods by now and judge accordingly. I do follow a very low-carb diet like Dr. Bernstein recommends, which is no more than 42 grams of carbohydrates per day. I also get a lot of exercise. Without both, it would be hopeless for me.

    Best regards,


  • 7 Candice // Aug 13, 2009 at 5:42 am

    I am 46 year old female — very slim — 5′2.5″ tall and 107 pounds. My fasting glucose has never been above mid 80s. However, my A1C is 5.1 which Dr. Bernstein says in unnacceptably high. Both my parents and only sibling have type 2 diabetes. My sibling and mother are obese, my father slim. I do take thyroid meds for hypothyroidism. I eat low carb to control my weight but since I am very slim and more active in the summer — I tend to overeat fruit in the summer. I try to take long walks every day — these range from 30 minutes to over an hour. I also tend to binge on nuts. My triglycerides are always very low — 45 or even lower — 22 at a recent test. How worried should I be about the 5.1 AIC??

  • 8 David Mendosa // Aug 18, 2009 at 7:19 am

    Dear Candice,

    Good question. I have a female friend who is also slim like you who is also concerned about an A1C level in the same range. But that range does seem to be a normal level, according to everything that I have been able to find. Normal, but perhaps not optimal. With a very low-carb diet, you can, as Dr. Bernstein recommends, bring it down to an optimal level.


  • 9 william // Aug 27, 2009 at 1:04 pm

    what about teas? I love green tea and use several types including Genmaicha (green tea with popped rice for a nutty finish) and green teas with various floral and fruit rinds for flavoring. Since I use loose leaf tea and steep directly, would I get a enough carbohydrate from the popped rice to matter? I just drink the tea, and use the solids for compost.

  • 10 David Mendosa // Aug 27, 2009 at 1:27 pm

    Dear William,

    White tea might be even better than green; see

    Enough carbohydrate? You don’t need any; see


  • 11 Rhonda Dothard // Oct 17, 2009 at 1:07 pm

    What about Symlin? Is anyone out there using symlin? I have been for 3 months, it seems to help with my sugar levels, as long as I exercise and don’t do too much high carbs.
    But I have found that exercising after a meal helps more than anything. I would like to hear from others using symlin. It has not been the miracle I was hoping for, but I have reduced my insulin.


  • 12 debby nielsen // Oct 27, 2009 at 7:06 pm

    Hi David,
    Thank you for this web site. Diagnosed with type 2 last year and had a recent a1c of 5.8 but am tired a lot and up at night to use the bathroom. Even though my a1c is good, could I still benefit from meds? Was on Junovia at one time and felt better.

  • 13 David Mendosa // Oct 27, 2009 at 7:58 pm

    Dear Debby,

    Since your A1C level is in the normal range, I wonder if something else is going on. Being tired and having to pee a lot are indeed symptoms of diabetes — but they are symptoms of UNCONTROLLED diabetes. If I were in your shoes, I would ask my doctor for a complete checkup.

    Best regards,


  • 14 Sandra // Oct 31, 2009 at 10:38 am

    what do you mean lo carb ? I thought we were to consume grains, vegetables,etc. Low,fat. I am so confused. I was just diagnosed, 10/21/09. I am supposed to meet with dietition. I also Take Metaformin.

  • 15 David Mendosa // Oct 31, 2009 at 11:20 am

    Dear Sandra,

    I do mean LOW carb — about 40 to 60 grams of carbohydrates per day. No more. Yes, the American Diabetes Association and most dietitians would you have a low fat diet instead. But it is the carbohydrates, not fat or protein, that raises our blood glucose levels and makes us unhealthy. I could go on and on about this, but please just start by reading my article “Why I Low-Carb” at

    Best regards,


  • 16 Janice // Feb 2, 2010 at 2:48 pm

    David, I agree with the others, you look fantastic! I didn’t realize that you were not taking any meds at this time. To me, this means you have reached a significant milestone in your personal battle with Type II. Congratulations!

    The last I knew, you were taking Byetta. Please expound on where your life has taken you since then.

  • 17 David Mendosa // Feb 2, 2010 at 3:27 pm

    Dear Janice,

    Thank you! You can find the best short explanation of what changed in my life since Byetta at

    But one addition: my A1C is now down to 4.8!

    Best regards,


  • 18 Janice // Feb 2, 2010 at 5:17 pm

    I just finished reading the link you sent me, “Why I Low-Carb”. What an inspiration!

    Many years ago, in my pre-diabetes younger years, whenever I needed to lose a few pounds, I’d go on a low-carb diet limiting my carb intake to 60 carbs per day until I lost the 10-15 pounds I wanted to lose. Then came the news that diets low in carbs but high in fat were not healthy, so I switched over to what I thought was the best of the best and began following a diet based on the glycemic index. I was no longer successful losing weight, it seemed, and somewhere along the way, I developed Type II. At least I was eating healthy, so I thought. Since my diagnosis, I’ve been struggling, trying to get my weight back under control and my numbers down. I’ve managed to lose only one-third of the weight I need to lose. My blood pressure is still too high and my cholestral numbers are still backwards (what should be lower is higher; what should be higher is lower). In my best efforts, I’ve never had an A1c below 6.0 and my meter readings have never been below 98. In fact, I feel ill whenever my meter reads a score of 100 or less!

    As usual, I have found inspiration at your website and a renewed passion to begin again, something I had lost along the way as I began to despair. Thank you for your continued efforts to share your knowledge of living with diabetes with the rest of us.

    I feel encouraged now. I have ordered a copy of Dr. Bernstein’s latest book, and tomorrow I will begin again: 6 grams of carbs for breakfast, 12 each for lunch and dinner, and 12 for a snack.

  • 19 Marilyn Hughes // Nov 2, 2010 at 9:18 am

    Your comments and information is inspiring! I’m trying very hard to control my A1C however am frustrated! I have never been obese but have lost approx. 15 lbs over past few years and now weigh 145 lbs. , height 5′ 7″ with my A1C around 7. I know that I ate too many high carbs this past summer so I know that I contributed directly to that number. On top of that I have other digestive problems which mean I cannot eat several foods i.e. peppers, onions plus am lactose intolerant. Knowing that lower is better, and I don’t want to gain weight I’m concern about my options. I have seen stats that some drugs (and insulin) can cause weight gain of up to 22 lbs. and I definitely do not want to gain weight. I’m on 2500 mg met, 1 Januvia per day. Plus I take PGX that I THINK helps but am not sure. Do these numbers indicate I should be moving directly to insulin? Appreciate your comments.

  • 20 David Mendosa // Nov 2, 2010 at 10:38 am

    Dear Marilyn,

    I don’t think that your numbers say that you have to go on insulin now, but that is a judgment call between you and your doctor, not something that I can tell you. The drugs that you take are some of the best in terms of not leading to weight gain (although Byetta and Victoza are much better, because they can help you lose weight). The main things that you need to do to bring your A1C down to a normal level is to follow a very low carb diet, like Dr. Richard K. Bernstein recommends in “Dr. Bernstein’s Diabetes Solution” and getting more activity. You can do it!

    Best regards,


  • 21 donna oman // Nov 30, 2010 at 1:47 am

    I haven’t read all the comments, but I just switched
    to brand name glucophage XL, just like Dr. Bernstein says, and it has really worked well! I can even have a small amount of whole grain bread! I have 0nly been on it about three months–my daily readings are about 80 to 95, as compared
    to 95 to 115 on the generic metformin–only drawback is my insurance company wont pay for the brand name, but it’s worth it to me to have the lower readings–no weight gain problems–give it a try–good luck–

  • 22 Joe // Feb 25, 2012 at 8:38 am

    I don’t get it. I thought A1c below 7 was good. How is 6.5 high?

  • 23 David Mendosa // Feb 25, 2012 at 9:21 am

    Dear Joe,

    The whole problem with diabetes is the complications. Diabetes itself causes nothing. But high blood glucose causes the complications. The best studies there are show conclusively that blood glucose levels above normal can cause complications. Please read my entire article about what a normal blood glucose level is. It’s at


  • 24 Lori // Nov 15, 2012 at 8:48 am

    I am a thin, healthy woman 5′7 120 lbs but have recent A1cs of 5.9 and 6.0. I had gestational diabetes with both pregnancies and after second, did not go away. I eat a very low carb diet bc I’d prefer not to use meds, if possible. But I generally try to keep postprandial readings under 140. Is that too high?

  • 25 David Mendosa // Nov 15, 2012 at 12:35 pm

    Dear Lori,

    Many people would say that 140 is not too high. But you can do better on a very low-carb diet even without drugs, by cutting out the starches and sugars. I know that my level is usually 80-90 and rarely above 100. That is safer!



  • 26 Valetta Kasal // Jun 17, 2013 at 6:28 pm

    I now know why the doctor’s office was freaking on me….I had labs done last Friday and my A1C is 9.9, Glucose 267…..lots of others were high as well. I was given a two week period of time to get the A1C going down – what are the best foods to do this?

  • 27 David Mendosa // Jun 17, 2013 at 8:34 pm

    Dear Valetta,

    It’s not the foods that you need to eat but those you need to avoid. Foods high in carbohydrates are those that raise your blood sugar level. These are particularly grains, especially wheat and anything made from it (bread, muffins, cake, pasta, etc.), corn, rice. Also avoid potatoes. Those are not all, but are the worst ones for you.



  • 28 Jessica // Jul 9, 2013 at 8:47 pm

    At my last doctor visit, my a1c came back at 6.0. I’m pleased, but would like to get it down further. I asked the doctor for suggestions, and she said that number was just fine – normal – and so I didn’t really need to. I don’ t agree. I already eat fairly low carb so is increasing my exercise my best bet? I take 2000 of Metformin a day, no other diabetes drugs.

  • 29 David Mendosa // Jul 9, 2013 at 11:17 pm

    Dear Jessica,

    I agree with you that 6.0 is not good enough. We can do better and reduce the risks of complications. But I think that going even lower carb will make more of a difference than exercise, except perhaps after meal exercise like I just wrote about today at HealthCentral.



  • 30 george cordenner // Jul 16, 2013 at 9:33 am

    Hello! I am a skinny diabetic. I am 6 feet, one inch and weight 166 lbs. I am a male . My last a1c was 6.4 and my doctor was not concerned also my diabetic dietition says wheat bread and wheat products are slowly digested and are ok

  • 31 David Mendosa // Jul 16, 2013 at 11:16 am

    Dear George,

    Isn’t it sad that so many people still believe that wheat and wheat products are good for us! It’s sad too that their standards of blood sugar control are so lax. No wonder that so many of us get complications from diabetes.



  • 32 george cordenner // Jul 16, 2013 at 11:58 am

    if wheat products are slowly to digest and do not raise blood sugar rapidly, then why do you feel against them. is there some empirical evidence suggesting otherwise

  • 33 David Mendosa // Jul 16, 2013 at 12:16 pm


    Actually, wheat products are some of the foods that we digest the FASTEST. The glycemic index studies all show this. See:

    Also please read my review of the book “Wheat Belly” at and the book itself. It will change your life.



  • 34 Barbara // Oct 4, 2013 at 2:14 pm

    I have an A1C of 6.0. My cholesterol is borderline high as well, and I was told to stay with whole grains because of the valuable fiber content. Is it the whole wheat by itself that raises glucose or just the amount you eat? Between trying to reduce cholesterol, blood pressure and now blood glucose I have no idea WHAT’s safe to eat!

  • 35 David Mendosa // Oct 4, 2013 at 2:34 pm

    Dear Barbara,

    Fiber may be useful, although not everyone agrees and we certainly have been ways of getting it in any case than eating grain. Nuts and seeds and even some fruit like avocados are loaded with fiber. A book that you really need to read, “Good Calories, Bad Calories,” by Gary Taubes has an entire chapter on fiber. He shows that we really don’t need it, at least through the consumption of grains. He shows evidence that the very few studies that “try” to link low-fiber intake to an increased chance of colon cancer are unfounded. Dr. Michael Eades has an eye-opening post on fiber too. Please see:



  • 36 vanessa // Oct 5, 2013 at 6:03 pm

    Hi I am a 49 yr old female 5ft 5inches 118pds.I have always had good glucose levels and numbers.I just got my A1C test back which was 5.9 would like to know how I can lower it.I am not a diabetic do have family history of it.

  • 37 David Mendosa // Oct 5, 2013 at 7:44 pm

    Dear Vanessa,

    Since you don’t have diabetes (yet), you probably have only one choice (which may be in two parts). You can’t usually get a prescription for a diabetes medication unless you already have it (sometimes your doctor will prescribe metformin for people with pre-diabetes, which it sounds like you have). Your choice, part 1, is to lose weight if you are overweight, i.e. have a BMI above 25 (see ). In any case, your best course of action is part 2, to eat fewer carbohydrates, particularly those with a high glycemic index (see ).



  • 38 Vanessa // Oct 5, 2013 at 9:37 pm

    Thanks for your response David I appreciate it. No I am not overweight my BMI is like a 19 or 20.I weigh only 118 pounds and I am 5 ft 5 inches tall.I am afraid if I start on a low carb diet I will lose weight but I am more afraid of diabetes.Do you know what types of foods I can eat that can help me avoid losing weight and still keep my A1C levels under control.The doctor said I was at risk for pre-diabetes will take this test again in a couple months.

  • 39 David Mendosa // Oct 6, 2013 at 12:39 pm

    Dear Vanessa,

    What you need to eat are exactly those good foods that I usually have to sacrifice in order to get my weight down to my goal! I try to stay thin and keep my BMI at 19.5. When I do have it down there (right now after lots of travel I have 3 pounds to lose), I eat avocados, cheese, and macadamia nuts. All of these foods, and many more, have lots of the best fats. I know from my own experience that it’s easy to put on pounds when I eat as much of them as I like!



  • 40 Earl Stone // Jan 23, 2014 at 6:05 pm

    I am a 44 yr male. 220 pounds. 5/7. I was currently diagnosed with type two. A1c was 7.9. I’m currently taking meteformin. Question. I been walking two . Three miles almost daily. Trying to eat right. Is 7.9 very bad. With my changes in diet and exercise will this lower my numbers. When I walk numbers come down. Meteformin reduces the numbers with good results. Signed. Nervous abourt this disease. Thanks

  • 41 Tom // Jan 23, 2014 at 6:33 pm

    A1C 13,stopped taking insulin because I could not (for 13 years)get my shoulder fixed,stopped exercise,now I went to a DR outside of the VA,surgery on hand scheduled soon,pre op screening means I must take insulin again,how much insulin is safe to take 2x a day

  • 42 David Mendosa // Jan 23, 2014 at 7:22 pm

    Dear Tom,

    That’s not a question that you can get a sound answer from here. You need to discuss it with your medical team because there are so many variables.



  • 43 David Mendosa // Jan 23, 2014 at 7:23 pm

    Dear Earl,

    Good question, but you didn’t say what your diet is. If you cut down on your starches (grains, potatoes) and eat less, your A1C will indeed come down to normal.



  • 44 Sarah // Mar 5, 2014 at 1:46 pm

    Dear David,
    I was just diagnosed with type 2 diabetes and my A1C was 8.7. My diet consisted of mostly carbs (white bread and pasta) and lots of soft drinks. Since being diagnosed I have completely changed my lifestyle. In 3 months I’ve lost 30 pounds, I haven’t had a soft drink, and I have reduced my carb intake greatly (between 4-6 servings a day) also any rice or bread is whole wheat. I am taking metformin but only 250mg 2x/day.
    Is it possible for me to get to a normal A1C if I continue on this route or was my A1C too high to bring down to “normal” non-diabetic level?
    I had one Dr. tell me it was possible to reverse my diabetes, because I am young and because he said I eat too much, that if I cut down my food intake I`ll be able to reverse it. Possible? or not?

  • 45 David Mendosa // Mar 5, 2014 at 2:06 pm

    Dear Sarah,

    Yes, indeed, you can put your diabetes into remission where you won’t suffer its consequences (complications) and be healthier and happier than ever before. You will need to get down to a low body mass index (i.e., lose a lot of weight) and get your A1C down to 5.5 at least. You are doing great and are on the right path. But you will almost certainly need to go farther. Whole wheat bread and brown rice are in fact little (if any) better than the usual. Unless you eat very little of these flours and grains you will find it very difficult to manage your diabetes. The good news is that you can give up the grains and feel much better too.



  • 46 Karen Okamoto // May 18, 2014 at 8:57 am

    Dear David, I followed you, and Dr Rollo when my daughter got diabetes at 10years old. She is 32 now, and her 4 year old son has Type 1 diabetes as well. I am almost 69 and got type 2 about 9 years ago. I went on insulin almost immediately. ( I suspect latent type 1. I set up my own insulin regimen and see a regular physician. My a1c is 5.4 right now. I have decided I should see an endocrinologist however as there seem to be so many new developments on the horizon. Could you recommend some endos in the Kansas City area?

  • 47 David Mendosa // May 18, 2014 at 10:57 am

    Dear Karen,

    The only information I have is Jimmy Moore’s list of low-carb doctors. It’s at:



  • 48 Jessica // May 28, 2014 at 9:51 am

    Dear David,

    Again, thanks for all you do to help diabetics (and those who hopefully may avoid diabetes) through education.

    In the last three months, I went from a personal low A1C of 5.4 up to a 5.7 and I am very concerned. I am a type 2 diabetic, taking metformin only, at 1000 mg. a day. I have lost a lot of weight, but my weight has stabilized.

    I did recently have some stressful things in my life, including having gallbladder removal and starting a new job. Could that really make my A1C jump that much in the course of four months? My diet has been somewhat less strict, but basically I’m eating around the same.

    Saddened by my backslide…..


  • 49 David Mendosa // May 28, 2014 at 3:04 pm

    Dear Jessica,

    The rise in your blood sugar was probably due in large part to stress. If so, this makes it all the more important not to get stressed out about it. You have shown that you can control your blood sugar once, and you can certainly now do it again.



  • 50 Dan H // Dec 7, 2014 at 10:03 pm

    Hi David

    Thanks for all you do. 45 years old and got diagnosed this week with a 6.5. First blood test ever. I’m 6′ and 185 lbs. Typically walk 12-16 miles weekly plus winter hiking. Pretty good diet. Problem is I figured I’ve been drinking a shocking 184 grams of sugar a week via alcohol. Peppermint Schnapps and beer. I also smoke on those 3 nights I typically drink. So that’s now done. Do u think I cut out the alcohol and smokes with increased walking to 20 miles weekly I can get that number down to something normal, say in the high 4’s/low 5’s? I’m convinced the booze is the culprit as I eat pretty well and regularly exercise. Not an alcoholic but drink socially with the neighbors so stopping that won’t be difficult. Thanks

  • 51 David Mendosa // Dec 8, 2014 at 2:00 pm

    Dear Dan,

    I am glad to help. Beer could indeed be your problem causing you to consume too many carbs. It is far higher in carbs than any other alcoholic drink. And it is a decided plus that you will not be smoking any more now that you have stopped drinking it. You can indeed get your A1C down into the normal range by reducing the amount of carbohydrate you eat (and drink). Keep testing your A1C level regularly for confirmation.

    Best regards,


  • 52 Sanober ayoob // Dec 27, 2014 at 9:39 pm

    My AC1 is 7.4 and have been a diabetic for 30 years and have been on Glyburide Metformin , my
    Doctor just increases the dosage to 1000 mg in the morning and 1000 mg in the night, is glyburide Metformin a good medication? I understand that I need to control carbs but am more confused if my medication is effective.

  • 53 David Mendosa // Dec 28, 2014 at 11:05 am

    Dear Sanober,

    I understand your doctor’s decision. He or she wants you to bring your A1C level down to no more than 7.0, which is a standard (although I am convinced that it should be much lower, less than 6.0; but that’s a different question). Increasing the amount of your medicine is necessary unless you reduce the amount of carbohydrates you eat. It should be effective and the metformin part of the medicine is the safest medicine for diabetes of all except for insulin, and the dosage your doctor prescribed is the standard maximum level. The Glyburide is, however, a medicine that I would not want to take because of some suspicion that it might burn out the beta cells of your pancreas (the cells that make the insulin in your body). Glyburide, like all sulfonylurea drugs, do that.

    With metta,

  • 54 Anthony Hoffman // Feb 9, 2015 at 3:27 pm

    I am a 53 y/o male and I thought in great shape, until my blood work showed a 5.9 A1C. I stand 5′4″, weigh 138 lbs, have a 29-30″ waist (since high school) and exercise 5 to 7 days a week. Cardio, weights, core body and swimming- normally swimming 2 days a week. My weight has always been steady and diet was always “healthy” with the exception of drinking a caffeinated soda daily, I also eat rice at least once a day (normally twice) and I love cookies and donuts. Well, I guess I will be cutting a lot of that out. Finally, I know I do not get enough sleep (4-5 ours daily). (BTW- there is no history of diabetes in our family)

    After reading your blog, I have several questions;
    1) How worried should I be about my A1C developing to an uncontrollable level (diabetes).
    2) Could the stress from all the exercise & lack of sleep be causing the elevated A1C?
    3) Besides cutting back on the carbs & soda what other dietary suggestions do you have?

    Thank you

  • 55 David Mendosa // Feb 9, 2015 at 3:44 pm

    Dear Anthony,

    An A1C of 5.9 probably means that you have pre-diaberes, but you are right on the cusp of diabetes. You are smart to be taking action now because you have a good chance of never getting diabetes, which has no cure. Pre-diabetes does have a cure. Of course, if you don’t make any changes in your diet, you will get diabetes.

    Stress and lack of sleep can indeed cause a higher blood sugar level, but it’s generally much less of a factor than poor diet. By poor diet I mean eating foods that will impact your blood sugar level. Those foods are the ones that are high in carbohydrates, including the grains, like rice and anything made from wheat. Potatoes also have a great impact. The other major change I’m guessing that you need to make is to avoid sugar as much as possible. While technically, there are many types of sugar, the problematic ones are fructose and sucrose.

  • 56 Cheryl // Mar 1, 2015 at 2:01 pm

    My a1c a year ago was 9..9 in July was down to 7.9 and down to 5.9 now. I am on metformin 2,000 a day and Glipside twice a day. I have lost 15 ponds but my height is 5′ and I weigh 164. But I have been exercising 4 days a week. Just not losing weight and my sugars are running a little higher now around 130. What can I do to get it lower and lose weight

  • 57 David Mendosa // Mar 1, 2015 at 2:11 pm

    Dear Cheryl,

    I am sure that you know your basic problem. With the height and weight numbers you provided your BMI is 32.0, and that puts you well into the obese range. You have two good choices, and the best is to immediately begin to follow a very low-carb diet, as I have written in many of my articles here. The other is to get your doctor to prescribe one of the new GLP-1 medications, Bydureon or Victoza. Actually, what worked best for me and for many people it to do both.

    Best regards,

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